From enrollment to coverage to claims – health insurance concepts can be difficult to keep straight. Your health is important and so is asking questions. We gathered the most common questions our customer service representatives are asked, with answers from our experts.
Question: "Can you help me understand how my plan works?"
Answer: Be sure to call the number on your ID card. Insurers, such as UnitedHealthcare, have representatives who use data and insights to empower you to make informed health care decisions. They are a great resource that can help save you time, stress and money. If you prefer using digital resources, that works too as they are helpful in explaining insurance concepts such as the difference between in-network vs. out-of-network care, or what your deductible amount is – the amount you’ll have to pay for covered services before the insurance starts paying.
Question: "Can you give me some information about claims?"
Answer: Specific claim details such as covered costs, contractual agreements or member responsibility may be found through your insurer’s online tools or by calling the number on your ID card to speak with a representative.
Question: "Can I change my health insurance or add a new family member to my plan during the year?"
Answer: One of the things you can count on in life is change. Whether it’s the birth of a new baby, a marriage, retirement or loss of a loved one, there are many family-related life events that may open the door for you to qualify to sign up for health insurance outside the annual open enrollment period. Usually, you’ll need to make changes within 30 or 60 days of your qualifying life event, depending on your plan. If you miss this deadline, you may have to wait until the next open enrollment.
Question: "Do I need to pay for my annual physical?"
Answer: Preventive care helps you stay healthier and many plans cover the cost, as long as you stay in-network. This can include routine well exams and physicals, screenings and immunizations intended to prevent or avoid illness or other health problems. For more information about how to estimate cost of care, click here.
Question: "Is my new medication covered? Do I have prescription coverage?"
Answer: Online tools or a representative can assist you with specific details about your prescription coverage such as your plan’s formulary list, prescription tier information and pharmacies you can visit in your area. Did you know that many doctors now have a real-time tool to check the eligibility of your prescription medication coverage, along with out-of-pocket costs that you might incur at the pharmacy?
More questions? Check out the UHC Newsroom, which has helpful videos such as “Health Care 101” and easy-to-understand articles about health insurance and wellness topics.